Discuss the following question: What would you recommend that David do, aside from beginning to look for another position? Each student must comment on at least 1 or 2 other student’s posts.
F, Search E
Several of UTHS’s hospital have been in existence for more than 100 years. Many of the system’s facilities are dated, and the system has very modest amounts of philanthropy, endowments, and research. Further, the metropolitan market served by UTHS is large and overbedded. Recruitment of physicians who have large practices and regional / national reputations could help UTHS bring new business to the system, but competition for such physicians is fierce. Overall physician compensation within UTHS’s market has been bid up above national averages, even when factoring in the local cost-of-living differential.
A New Vice President for Ambulatory Care
A new corporate vice president (VP) for ambulatory care has recently been recruited to help develop and implement strategies to expand the ambulatory care service line for the system. At this time, inpatient services represent approximately 75% of UTHS’s operating revenues, and outpatient services represent the remaining 25%. In contrast, the national averages are hovering around 55/45 for the inpatient / outpatient revenue mix.
Each of the UTHS hospitals has vice presidents for ambulatory care who would report to the new corporate VP on the dotted line, with their primary reporting relationship remaining with the local hospital’s chief operating officer (COO) or president. The new corporate VP would directly report to UTHS’s COO and also have a dotted-line reporting relationship to the local hospital presidents and chief operating officers. This structure is commonly referred to as a matrix relationship.
David Harris, who has spent his entire career successfully managing ambulatory care services and physician practices, has been offered the position. During his recruitment, he had been told by UTHS’s COO that all of ambulatory care would be removed from the authority of the local hospitals and placed into an enterprise under his responsibility. Although skeptical about the strategy, David did not voice any negative opinions about it during the recruitment process. The COO at CTHS had a reputation for getting what he wanted, and David did not see any upside in trying to change the COO’s mind during the interview process.
After reviewing the UTHS financials prior to accepting the position, however, David was convinced that he would have limited capital to work with in attempting to develop a larger ambulatory care footprint. Lacking a strong balance sheet, and further limited by slim profit margins and a small amount of endowment, David knew capital resources would be scarce. His experience in other major healthcare systems suggested that, when push came to shove, ambulatory care was always last in line after all of the inpatient needs were funded. However, he had enjoyed maneuvering on this very narrow tightrope in his past positions, so these concerns did not scare him away from accepting the offer.
Clarifying the Challenge Ahead
Once David came on board, he decided to spend the first 8 to 12 weeks visiting all of the hospitals and ambulatory care facilities and meeting with the hospitals’ senior management, including the vice presidents from ambulatory care who would have a dotted-line reporting relationships to him. During these visits, David immediately found that, although many of the senior managers were warm and friendly, none of them were particularly interested in giving up responsibility for any of their ambulatory care enterprise, in spite of the edict of the UTHS’s COO. In some cases, managers directed overt hostility at David. At one hospital, the local vice president for ambulatory care refused to share any financial or operating performance information with David, under instructions from her hospital’s president. In another hospital, the local vice president for ambulatory care refused to meet with David at all.
After visiting all the ambulatory care services throughout UTHS, David summarized what he had found: 1. Most of the facilities and services has been underfunded and undermanaged for years. 2. Meaningful financial and statistical information did not exist.
- A direct ratio seemed to exist between the distance from the main campus and the managerial interest in the various ambulatory care service assets, especially the physician practices.
- No one was evaluating the overall performance of the ambulatory care services, and because no ambulatory care strategy had been delineated, the services lacked data with which to benchmark performance or the appropriateness of each asset.
Sample Solution
The socio-political scene of race has changed incredibly as regulated supremacist structures have been tested, disassembled, and rethought as per increasingly fair and therapeutic qualities. These progressions have stretched out into the administration, with an expansion in the political decision and re-appointment of administrators of differing racial and ethnic personalities, including the memorable appointment of Barack Obama as president. In his book Congress in Black and White, Christian Grose presents his bound together hypothesis of African American portrayal in Congress. In his work, he investigates ethnic governmental issues, and the multidimensional variables that impact authentic dynamic in Congress. He looks at how portrayal has changed with the rising of lawmakers and administrators who have a place with verifiably minimized networks, some of whom speak to lion’s share white areas. At last, he looks to inspect how dark portrayal in Congress influences minority networks. So as to increase a total perspective on portrayal, Grose utilizes a multifaceted methodology that includes investigating and looking at officials from different kinds of locale. For instance, he investigates the truly new marvel of dark administrators speaking to lion’s share white locale so as to all the more likely comprehend whether dark officials’ inclinations in pushing for dark premiums are their very own direct result race or in light of the race of the electorate which they speak to. His system permits him to break down the impact of both the racial cosmetics of the electorate and the racial character of lawmakers. After utilizing this procedure, Grose finds that “the race of the lawmaker isn’t as considerably significant as the hidden racial cosmetics of the voting demographic,” and that thus “administrators speaking to dark lion’s share locale will cast a ballot for enactment meaningfully in light of a legitimate concern for dark Americans substantially more than officials speaking to areas without a dark lion’s share” (16). He looks past clear portrayal by “examining late Congresses with dark officials from both dark dominant part and dark minority locale” to increase a progressively comprehensive and complete comprehension of dark Congressional portrayal” (Grose 17). In this way, with regards to portrayal, it is imperative to take a gander at the racial cosmetics of the voting demographic alongside the race of the lawmaker. Grose’s bound together hypothesis of African American portrayal in Congress can be applied to Maxine Waters, an African American congresswoman of the Democratic party who right now serves California’s 43rd region, in the South Los Angeles County. His hypothesis can be utilized to investigate how as an African American congresswoman, Waters keeps on bringing considerable portrayal and proactive enactment that serves and advantages the African Americans of her area, just as others of shading in her differing electorate. Grose’s hypothesis of brought together portrayal holds that three contending speculations in regards to race and meaningful portrayal are altogether indicators of how agent a lawmaker will be of their constituents and make a move on the issues that most influence them. As per Grose, the three indicators are: “(1) equitable agents lead to higher considerable portrayal; (2) dark officials lead to higher meaningful portrayal; and (3) the higher the dark populace of a locale, the higher the meaningful portrayal” (20). Maxine Waters, a Democrat, and an African American, serves a locale where African Americans are the second biggest gathering after Hispanics. Maxine Waters has a long history of battling for racial equity, both broadly and abroad. In an article for the L.A. Times, Richard Paddock perceives Waters’ responsibility to the reason for racial equity when she composed enactment planned for stripping from South Africa as a result of its politically-sanctioned racial segregation system during the 1980s. She contradicted the Iraq War and condemned the Republican administrations of George H. W. Shrubbery, George W. Shrub, and Donald Trump, even co-supporting H.R. 140 censuring the arrangement of Steve Bannon to the National Security Council and requiring his expulsion. As expressed on her official site, Waters was first chosen for Congress in 1990 and has been reappointed for a considerable length of time since. Waters has served California’s 43rd area since 2013 and preceding this, she served California’s 35th and 29th congressional locale, which as indicated by the Census Bureau are both exceptionally differing areas. California’s 43rd region, which Maxine Waters right now speaks to, is a racially differing congressional area situated in South Los Angeles County and incorporates Inglewood, Hawthorn, and Torrance. As per the U.S. Registration Bureau’s 2016 review, out of its populace of 724,077, 47% of the area is Hispanic, 21% African American, 15% White, and 13% Asian. Roughly 33% of the province’s occupants are outside conceived foreigners. The locale is a blend of numerous different ethnicities, including West Indian, Sub-Saharan African, Italian, and Arab. Factional casting a ballot designs in the course of the last a few races uncover that the 43rd locale has sequentially and overwhelmingly casted a ballot Democrat for Maxine Waters. As per the article “Rep. Maxine Waters (D CA-43)” on the online database InsideGov, in the 2016 political decision, Waters, the officeholder, got 76% of the vote, beating Republican Omar Navarro, who got 24% of the vote. In 2014, as the officeholder she got 71% of the vote, crushing Republican John Wood’s 29% of the vote. Also, in 2012, she beat Democrat Bob Flores with 71% of the vote. Waters has consistently exhibited a guarantee to meaningful portrayal for African Americans as well as for Hispanics. As indicated by Grose, clear portrayal for African Americans “is characterized as the appointment of dark officials to office” (3). While most of the constituents in her region are Hispanic, the second biggest gathering in her area are African Americans. Maxine Waters has given both expressive and meaningful portrayal for the ethnic minorities in her region. During her time as a Congresswoman, she has been focused on the interests of her African American constituents just as her locale’s Hispanic people group. Besides, Waters has advocated administration in liberal political qualities, for example, supporting Planned Parenthood, the ACLU, and human rights and as per GovTrack, most of the bills that Waters supports identify with Health (22%), Finance and the Financial Sector (17%), Crime and Law Enforcement (16%), and Education (10%). Destitution and lodging concerns are especially squeezing issues in Waters’ 43rd congressional locale. As expressed on the website page “California’s 43rd District” by the association TalkPoverty, which is an undertaking of Center for American Progress, in 2013, 21.4% of the populace had livelihoods underneath the neediness line, which included 32.6% of kids who originated from families with earnings beneath the destitution line, implying that 33% of the area’s kids live in neediness. Examined along racial lines, 24.7% of the region’s African Americans and 26.4% of the Latino populace live in destitution. Waters has viably worked for enactment to attempt to address the issues of her constituents. As indicated by InsideGov, Waters supported the Ending Homeless Act of 2017 including lodging and network advancement to end vagrancy by tending to the absence of moderate lodging and supported the Project-Based Voucher Improvement Act of 2015, which was ordered to improve the Housing Act of 1937, explicitly comparable to utilizing rental voucher help. Her record is broad with regards to tending to the issues that influence her principally African American and Hispanic voting demographic, predictable with Grose’s decision that “African American officials are substantially more liable to concentrate on the interests of African-American voters with regards to distributing government activities and body electorate administration to African Americans” (16). As expressed on InsideGov’s page, “Rep. Maxine Waters (D CA-43),” Waters cosponsored a bill to investigate issues that explicitly influence dark men and young men, called HR. 1194: Commission on the Social Status of Black Men and Boys Act, and she additionally co-supported H.R. 1135 to reauthorize the Historically Black Colleges and Universities Historic Preservation program. Her help for HBCUs is in accordance with Grose’s investigation that “dark agents apportion essentially a larger number of undertakings to HBCUs than white delegates in areas with huge rates of white voters” (157). Besides, Grose contends that “racial portrayal influences the distribution of ventures to dark constituents” (158). On account of Maxine Waters, it is apparent that she dedicates generous exertion in supporting administrative tasks that advantage her dark constituents. As an ethnic minority, she has likewise pushed for enactment in help of the non-dark ethnic minorities in her region. As indicated by InsideGov, in 2017, Waters additionally supported the Stop AIDS in Prison Act of 2017, which looked to address the absence of successful HIV/AIDS programs in Federal jails, since ethnic minorities are disproportionally overrepresented in the jail framework. She likewise co-supported the End Racial Profiling Act of 2017, which tended to racial profiling in wrongdoing and law implementation â a huge issue for the constituents of her greater part dark and earthy colored locale and H.R. 858: DREAMers, Immigrants, and Refugees Legal Aid Act, which straightforwardly mirrors the worries of the Hispanic and Latino individuals from her body electorate and the significant issues and battles that they face with movement arrangements. It is apparent that Waters has served both as an unmistakable and meaningful portrayal for African Americans which Grose characterizes considerable portrayal>
The socio-political scene of race has changed incredibly as regulated supremacist structures have been tested, disassembled, and rethought as per increasingly fair and therapeutic qualities. These progressions have stretched out into the administration, with an expansion in the political decision and re-appointment of administrators of differing racial and ethnic personalities, including the memorable appointment of Barack Obama as president. In his book Congress in Black and White, Christian Grose presents his bound together hypothesis of African American portrayal in Congress. In his work, he investigates ethnic governmental issues, and the multidimensional variables that impact authentic dynamic in Congress. He looks at how portrayal has changed with the rising of lawmakers and administrators who have a place with verifiably minimized networks, some of whom speak to lion’s share white areas. At last, he looks to inspect how dark portrayal in Congress influences minority networks. So as to increase a total perspective on portrayal, Grose utilizes a multifaceted methodology that includes investigating and looking at officials from different kinds of locale. For instance, he investigates the truly new marvel of dark administrators speaking to lion’s share white locale so as to all the more likely comprehend whether dark officials’ inclinations in pushing for dark premiums are their very own direct result race or in light of the race of the electorate which they speak to. His system permits him to break down the impact of both the racial cosmetics of the electorate and the racial character of lawmakers. After utilizing this procedure, Grose finds that “the race of the lawmaker isn’t as considerably significant as the hidden racial cosmetics of the voting demographic,” and that thus “administrators speaking to dark lion’s share locale will cast a ballot for enactment meaningfully in light of a legitimate concern for dark Americans substantially more than officials speaking to areas without a dark lion’s share” (16). He looks past clear portrayal by “examining late Congresses with dark officials from both dark dominant part and dark minority locale” to increase a progressively comprehensive and complete comprehension of dark Congressional portrayal” (Grose 17). In this way, with regards to portrayal, it is imperative to take a gander at the racial cosmetics of the voting demographic alongside the race of the lawmaker. Grose’s bound together hypothesis of African American portrayal in Congress can be applied to Maxine Waters, an African American congresswoman of the Democratic party who right now serves California’s 43rd region, in the South Los Angeles County. His hypothesis can be utilized to investigate how as an African American congresswoman, Waters keeps on bringing considerable portrayal and proactive enactment that serves and advantages the African Americans of her area, just as others of shading in her differing electorate. Grose’s hypothesis of brought together portrayal holds that three contending speculations in regards to race and meaningful portrayal are altogether indicators of how agent a lawmaker will be of their constituents and make a move on the issues that most influence them. As per Grose, the three indicators are: “(1) equitable agents lead to higher considerable portrayal; (2) dark officials lead to higher meaningful portrayal; and (3) the higher the dark populace of a locale, the higher the meaningful portrayal” (20). Maxine Waters, a Democrat, and an African American, serves a locale where African Americans are the second biggest gathering after Hispanics. Maxine Waters has a long history of battling for racial equity, both broadly and abroad. In an article for the L.A. Times, Richard Paddock perceives Waters’ responsibility to the reason for racial equity when she composed enactment planned for stripping from South Africa as a result of its politically-sanctioned racial segregation system during the 1980s. She contradicted the Iraq War and condemned the Republican administrations of George H. W. Shrubbery, George W. Shrub, and Donald Trump, even co-supporting H.R. 140 censuring the arrangement of Steve Bannon to the National Security Council and requiring his expulsion. As expressed on her official site, Waters was first chosen for Congress in 1990 and has been reappointed for a considerable length of time since. Waters has served California’s 43rd area since 2013 and preceding this, she served California’s 35th and 29th congressional locale, which as indicated by the Census Bureau are both exceptionally differing areas. California’s 43rd region, which Maxine Waters right now speaks to, is a racially differing congressional area situated in South Los Angeles County and incorporates Inglewood, Hawthorn, and Torrance. As per the U.S. Registration Bureau’s 2016 review, out of its populace of 724,077, 47% of the area is Hispanic, 21% African American, 15% White, and 13% Asian. Roughly 33% of the province’s occupants are outside conceived foreigners. The locale is a blend of numerous different ethnicities, including West Indian, Sub-Saharan African, Italian, and Arab. Factional casting a ballot designs in the course of the last a few races uncover that the 43rd locale has sequentially and overwhelmingly casted a ballot Democrat for Maxine Waters. As per the article “Rep. Maxine Waters (D CA-43)” on the online database InsideGov, in the 2016 political decision, Waters, the officeholder, got 76% of the vote, beating Republican Omar Navarro, who got 24% of the vote. In 2014, as the officeholder she got 71% of the vote, crushing Republican John Wood’s 29% of the vote. Also, in 2012, she beat Democrat Bob Flores with 71% of the vote. Waters has consistently exhibited a guarantee to meaningful portrayal for African Americans as well as for Hispanics. As indicated by Grose, clear portrayal for African Americans “is characterized as the appointment of dark officials to office” (3). While most of the constituents in her region are Hispanic, the second biggest gathering in her area are African Americans. Maxine Waters has given both expressive and meaningful portrayal for the ethnic minorities in her region. During her time as a Congresswoman, she has been focused on the interests of her African American constituents just as her locale’s Hispanic people group. Besides, Waters has advocated administration in liberal political qualities, for example, supporting Planned Parenthood, the ACLU, and human rights and as per GovTrack, most of the bills that Waters supports identify with Health (22%), Finance and the Financial Sector (17%), Crime and Law Enforcement (16%), and Education (10%). Destitution and lodging concerns are especially squeezing issues in Waters’ 43rd congressional locale. As expressed on the website page “California’s 43rd District” by the association TalkPoverty, which is an undertaking of Center for American Progress, in 2013, 21.4% of the populace had livelihoods underneath the neediness line, which included 32.6% of kids who originated from families with earnings beneath the destitution line, implying that 33% of the area’s kids live in neediness. Examined along racial lines, 24.7% of the region’s African Americans and 26.4% of the Latino populace live in destitution. Waters has viably worked for enactment to attempt to address the issues of her constituents. As indicated by InsideGov, Waters supported the Ending Homeless Act of 2017 including lodging and network advancement to end vagrancy by tending to the absence of moderate lodging and supported the Project-Based Voucher Improvement Act of 2015, which was ordered to improve the Housing Act of 1937, explicitly comparable to utilizing rental voucher help. Her record is broad with regards to tending to the issues that influence her principally African American and Hispanic voting demographic, predictable with Grose’s decision that “African American officials are substantially more liable to concentrate on the interests of African-American voters with regards to distributing government activities and body electorate administration to African Americans” (16). As expressed on InsideGov’s page, “Rep. Maxine Waters (D CA-43),” Waters cosponsored a bill to investigate issues that explicitly influence dark men and young men, called HR. 1194: Commission on the Social Status of Black Men and Boys Act, and she additionally co-supported H.R. 1135 to reauthorize the Historically Black Colleges and Universities Historic Preservation program. Her help for HBCUs is in accordance with Grose’s investigation that “dark agents apportion essentially a larger number of undertakings to HBCUs than white delegates in areas with huge rates of white voters” (157). Besides, Grose contends that “racial portrayal influences the distribution of ventures to dark constituents” (158). On account of Maxine Waters, it is apparent that she dedicates generous exertion in supporting administrative tasks that advantage her dark constituents. As an ethnic minority, she has likewise pushed for enactment in help of the non-dark ethnic minorities in her region. As indicated by InsideGov, in 2017, Waters additionally supported the Stop AIDS in Prison Act of 2017, which looked to address the absence of successful HIV/AIDS programs in Federal jails, since ethnic minorities are disproportionally overrepresented in the jail framework. She likewise co-supported the End Racial Profiling Act of 2017, which tended to racial profiling in wrongdoing and law implementation â a huge issue for the constituents of her greater part dark and earthy colored locale and H.R. 858: DREAMers, Immigrants, and Refugees Legal Aid Act, which straightforwardly mirrors the worries of the Hispanic and Latino individuals from her body electorate and the significant issues and battles that they face with movement arrangements. It is apparent that Waters has served both as an unmistakable and meaningful portrayal for African Americans which Grose characterizes considerable portrayal>
